الفهرس 
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Abstract
Occupational ILD result from inhalation of different types of dust and chemicals according to occupational hazards (Zosky et al., 2016), is an untreatable but preventable, and the level of risk of developing the disease varies according to the composition of the dust (Cullinan et al., 2017).
Occupational ILD is a long-latency disease that gradually develops over a prolonged period of exposure. In general, a history of at least 10 or more years of exposure to occupational hazards is required to develop it (Newbigin, 2019).
Despite that workers shouldn’t develop lung disease from going to work, no matter where in the world they live or their level of income too, while in the same time workers financially were unsupported and they preferred their families priority than their own health, so a safe work environment must be provided in a hazardous job as at Occupational Health and Safety laws around the world (Hoy, 2022).
Egyptian railway has a huge number of workers and employees at risk of being exposed to different occupational exposures as industrial dust, heavy metal dust, chemical vapours, gases, wood dust, Diesel exhaust and welding fumes which need more research. So our study was designed to determine the prevalence of occupational ILD among confirmed interstitial lung diseases patients admitted to the chest department of Egyptian Railway Medical Centre and the assessment of the outcome of both inpatients and outpatients from December 2020 to December 2021.
Our study was observational cross section study, One hundred and fifty five patients with confirmed interstitial lung disease according to ATS/ERS/JRS/ALAT statement (2018) admitted to the chest department of Egyptian Railway Medical Centre from December 2020 to December 2021. After the approval of the ethical committee of the Faculty of Medicine, Ain Shams University (FMASU M D 127/2020).The cases were divided into two groups: group (A) 79 patients with occupational exposure (38 Inpatient &41 Outpatient) and group (B) 76 patients with non-occupational exposure (25 Inpatient &51 Outpatient). Patients with Obstructive lung disease, Old TB patients, Lung cancer, lymphangities carcinomatosis, Pregnant or lactating women were excluded also those who didn’t want to participate in the study were excluded.
All patients were subjected to the following:-
1. Detailed history taking.
2. Full clinical examination, arterial blood gases on room air, laboratory findings, pulmonary function assessment (FEV1, FVC, FEV1/FVC), radiological assessment (chest x ray and high resolution CT scan).
3. Data about the hospital stay regarding inpatients in both groups were recorded.
The results obtained were collected, tabulated and submitted to statistical analysis.
from our result the prevalence of confirmed cases of interstitial lung diseases among occupational exposure was 1.49% while among the non-occupational exposure was 1.1%.
Range of age in occupational group was between (31- 68 years) and non-occupational group was between (41- 73 years), 93.6%, and 88.1% of occupational & non-occupational groups were males respectively. 81 % and 52.6 % of occupational group and non -occupational group respectively were non-smokers and 69.6 % only of occupational group was secondary degree educated. 72% of occupational group had a history of oxygen therapy before admission in comparison to 35 % in non-occupational group.
CXR findings was positive in 58.2 % and 30.2% of occupational and non -occupational group respectively while HRCT findings was mostly nodular in occupational group and mostly reticulation and GGO in non-occupational group and there was statistical significant difference between the out-patient of both groups.
There was statistical significant difference between the out-patient of both groups regarding spirometric parameters (FEV/FVC, FVC%& FEV1%) and there was more decline in spirometric parameters (FVC%&FEV1) in out-patient occupational than non-occupational group.
There was statistical significant difference between both groups regarding the length of hospital and oxygen received in hospital but there was not statistical significant difference between both groups regarding type of hospital stay as 47.1% of hospitalized occupational patient stayed between (11-15days),15.76% admitted to ICU and 5.2% Were mechanically ventilated while 48% of hospitalized non-occupational patient stayed between (6-10days), 8% only admitted to ICU and 4 % Were mechanically ventilated.
The length of hospital stay in occupational group was affected by times of exacerbation and increased total leucocytic count While in the non- occupational group affected by age, Po2, So2 and spirometric parameters (FEV/FVC, FVC % and FEV1%).